Investigação molecular dos vírus entéricos na etiologia de infecções virais do sistema nervoso central em amostras de líquor provenientes do hospital de base de São José do Rio Preto – SP

Abstract

Enterovirus (EV) is commonly associated with central nervous system (CNS) syndromes. Recently, gastroenteric viruses, including Rotavirus (RVA), Human Astrovirus (HAstV) and Norovirus (NoV) have also been associated with CNS neurological disorders. Objectives: The aim of the present study was to investigate the presence of EV, RVA, HAstV and NoV associated with CNS infections of unknown etiology at Hospital de Base, São José do Rio Preto/SP, and to conduct the molecular characterization of the positive samples. Material and Method: A total of 288 cerebrospinal fluid (CSF) samples collected from July to December 2017 were tested to EV and NoV by RT-qPCR, HAstV by conventional RT-PCR, and RVA by ELISA. Positive-EV samples were inoculated in cells lines Hep2 e RD and after, the VP1 gene was amplified and sequenced. Results: RVA, NoV and HAstV were not detected. EV infection was detected in 5.5% (16/288) of the samples, and five of them were genotyped, being identified the Echovirus 3 (E3) (1/5), Coxsackie A6 (CVA6) (1/5) and Coxsackie B4 (CVB4) (3/5) viruses. Meningitis was the main syndrome observed (12/16; 75%). The genotypes E6, CVA6 and CVB4 were identified associated with aseptic meningitis. Conclusion: The present investigation showed the circulation of diverse EV types in a small regional sample set and in a short period of time, highlighting the importance of an active EV surveillance system in CNS infections. The improved understanding of CNS infections of unknown etiology will help the municipality's public health system to plan the surveillance actions in these cases.